ST. LOUIS — When the U.S. Supreme Court justices heard arguments for and against federal COVID-19 vaccine mandates Friday, Missouri's attorney general's office was at the center of the case.
"Today, both of those cases were argued in front of our nation's highest court, representing two of the most important cases to be argued in the Supreme Court's history," Missouri Attorney General Eric Schmitt said in a press release.
Schmitt did not argue before the court. Instead, Deputy Attorney General Jesus Osete told the justices mandates could dramatically hurt staffing at rural healthcare providers if workers refused the shot and walked off the job.
But the attorney for the Biden administration told the justices the federal government can set regulations that come with accepting federal Medicaid and Medicare money.
"About $.50 of every Medicaid dollar is federal money," said Robert Gatter with Saint Louis University Law School. "So, the federal government gets to set conditions," he said.
"They can't be irrational about it. But it's hard to say it's irrational to require that...that they would get a vaccine that's been shown effective against all the strains so as to minimize the risk that they are actually harming the patients who they're there to help," said Gatter who specializes in healthcare law.
And the justices that had questions of Schmitt's deputy seemed to agree.
Justice Elana Kagan said of the message from federal regulators to healthcare workers "you have to get vaccinated so that you're not transmitting the disease that can kill elderly Medicare patients, that can kill sick Medicaid patients."
"But your honor, here we're dealing specifically with a vaccine requirement that again has historically been in the states' province," said Osete the deputy attorney general. "If Congress wants to give that authority to CMS, the federal agency here, it has to do so in exceedingly clear language."
CMS is the Centers for Medicare and Medicaid Services which oversees the programs.
Gatter says what he did not hear in court today is significant. No hospital systems or health care providers have stepped up to tell the court they oppose the mandate.
"And that would tend to suggest that those who are in the trenches also see that this while this is a difficult balance of risks to judges, this is the right way to go that ultimately safety has to take the lead at least till we get through this next wave," Gatter said.
On the other mandate before the court, the justices seemed less sympathetic.
That one deals with the requirement that businesses with more than 100 employees either require the vaccine or require masks and regular testing.
It's not clear how soon the court might rule.
The mandate is blocked in 24 states while it works its way through courts.